COMBINED GUIDED TISSUE REGENERATION, ROOT CONDITIONING, AND FIBRIN-FIBRONECTIN SYSTEM APPLICATION IN THE TREATMENT OF GINGIVAL RECESSION - A 15-CASE REPORT

THIS PAPER DESCRIBES A SURGICAL TECHNIQUE to achieve root coverage in deep, wide gingival recessions using a root isolation procedure with e PTFE membrane, combined with tetracycline conditioning of the root sur face and fibrin-fibronectin sealing system application. The technique was used on 15 patients with isolated mucogingival defects 4 to 6 mm d eep. A large trapezium-shaped flap was raised 3 to 4 mm apical to the margin of the bone dehiscence. The root surface was thoroughly scaled by hand and rotating instruments. Tetracycline HCl solution (100 mg/ml ) was topically applied for 4 minutes. Expanded polytetrafluoroethylen e (ePTFE) membrane was adapted at least 1 mm coronal to the CEJ and re tained in position by sling sutures. A film of fibrin-fibronectin seal ing system was injected between the membrane and the root surface. The flap was sutured coronally and the membrane removed 6 weeks later. Th e patients were reevaluated 6 months after the reentry procedure. The mean recession depth decreased from 4.7 mm initially to 1.1 mm at the final postoperative appointment. This represents a mean root coverage of 77.4%. Mean probing depth reduction was 0.9 mm and the mean width o f keratinized tissue increased from 1.8 mm preoperatively to 2.9 mm 6 months after surgery. These findings show that the treatment of buccal gingival recession using guided tissue regeneration procedure plus te tracycline root demineralization and fibrin-fibronectin glue applicati on results in a consistent and predictable improvement of mucogingival defects.